2013 Medicare star ratings show some changes

CMS released Medicare Advantage rates on October 12th just in time for the 2013 open enrollment period. The results show a 20% increase in the number of 4.5 and 5 star Medicare Advantage plans for 2013. According to a CMS press release, 37% of all Medicare Advantage members are in a 4-star or higher rated plan.

There was some movement at the top with five new 5-star MA plans added to the list and two MA plans from 2012 receiving slightly lower ratings. One PDP plan was replaced amongst the top ranking plans in 2013.

Downloading the plan ratings and analyzing the data resulted in the summary table below.

Summary of 2013 Medicare Star Ratings


As in 2012, less than 3% of all MA plans received the highest possible rating while 10% of plans received 4.5 stars out of 5. Just over 5% of PDPs received 5 stars and another 5% received 4.5 stars in 2013.

Only 10% of MA plans fell below the 3-star threshold this year. Over 20% of plans are too new or received too few survey responses to be rated. Similar proportions of PDPs received less than the minimum acceptable rating of 3 stars or were unrated in 2013.

Two MA-PD plans slipped from 5-stars in 2012 to 4.5 stars in 2013 (Martin’s Point Health Care, Inc and Security Health Plan). One PDP fell from 5-stars to 4.5 stars in 2013 (ODS Health Plan).

The top health plans based on 2013 Medicare Star ratings are:

MA-PD
  • Group Health Cooperative (WA)
  • Group Health Plan, Inc. (MN) – new for 2013
  • Gundersen Lutheran Health Plan, Inc. (WI)
  • Health New England / Baystate Health, Inc. (MA)
  • Humana Wisconsin (WI) – new for 2013
  • Kaiser Foundation Health Plan, Inc. (CA)
  • Kaiser Foundation Health Plan, Inc. (CO)
  • Kaiser Foundation Health Plan, Inc. (HI)
  • Kaiser Foundation Health Plan (OH) – new for 2013
  • Kaiser Foundation Health Plan of the Mid-Atlantic States (MD/VA) – new for 2013
  • Kaiser Foundation Health Plan of the Northwest (WA)
MA Only
  • Dean Health Plan, Inc. (WI)
  • Kaiser Foundation Health Plan, Inc. (CA)
  • Medical Associates Health Plan, Inc. (IA & IL)
  • Medical Associates Health Plan, Inc. (WI) – new for 2013
PDP
  • BCBS MN, MT, NE, ND, WY, Wellmark IA and SD / MedicareBlue Rx
  • Catamaran Insurance Of Delaware, Inc. (DE) – new for 2013
  • Excellus Health Plan, Inc / Lifetime Healthcare, Inc. (NY)
  • Hawaii Medical Service Association (HI)
The number of members a plan has does not seem to impact its ability to achieve a 5-star rating. Kaiser has the largest MA-PD plan in the nation, as well as, one of the smallest MA-only plans, yet both achieved 5-star status. The multi-state MedicareBlue Rx plan is one of the largest PDPs in the country and it also received a 5-star rating.
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